초·경산부의 출산 연령에 따른 후기조기분만 발생 빈도에관한 연구; 2008~2012년 단태아 인구동태통계 중심으로
Incidence of Late Preterm Birth in Primi- and Multiparous Women by Maternal Age; 2008~2012 Singleton Birth Certificate Data of Korea
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
본 연구는 통계청의 2008년부터 2012년까지 원시자료 중 출산 연령 20세 이상, 임신 34주 이상, 단태아의 출생 자료(2,227,741건)를 기초자료로 활용하였다. 출생 년도, 출생아 성, 학력, 직업, 혼인 상태 등의 변수를 이용하여 초산 및 경산부의 출산 연령별 후기조기분만 발생 위험도를 추정을 위해 로지스틱 회귀분석을 시행하였다. 출산 연령 분포는 20~24세 5.5%, 25~29세 32.1%, 30~34세는 45.9%로 점유율이 가장 높았으며,35~39세 14.6%, 40세 이상은 1.9%였다. 출생순위는 첫째아의 점유율이 51.7%, 둘째아 이상이 48.3%로 나타났다. 임신기간 분포에서는 임신 34~36주 후기조기분만 빈도는 3.5%였으며, 출산 연령별 후기조기분만 발생 빈도에서 20~29세 초산부는 3.0%로 가장낮았고, 경산부는 3.7%, 30~34세의 경우 초산부와 경산부 모두 발생 빈도가 3.4%로 동일하였고, 35~39세는 초산부 4.5%, 경산부 4.2%, 40세 이상에서는 경산부가 6.5%로 초산부의 5.9%보다 발생 빈도가 높았다. 출생아의 성, 혼인 상태, 교육수준, 직업유무 등의 변수를 이용한 로지스틱 회귀분석 결과 후기조기분만의 발생 위험도(교차비)는 20~29세 초산부에 비해 20~29세 경산부의 교차비는 1.18, 30~34세에서는 초산부1.13 경산부 1.14, 35~39세에서는 각각 1.47, 1.38,40세 이상에서는 초산부는 1.89, 경산부에서는 2.06으로 나타나 출산 연령이 증가함에 따라 후기조기분만위험도가 증가하였으며, 동일 연령군에서 초산부가 경산부보다 발생 위험도가 일관성 있게 높게 나타나지않았다.
Abstract
Purpose: The objective of this study was to compare the incidence of late preterm (34~36 weeks:LP) birth in primi- and multiparous women aged 30~34, 35~39, and ≥40 years with primiparouswomen aged 20~29 years. Methods: Odds ratio of LP birth by maternal age and 95% confidence intervals (CI) were calculatedfrom logistic regression analyses adjusted for maternal and infantile variables (year of birth,infantile gender, marital status, maternal education and occupation). We used 2008~2012 singletonbirth certificate data of Korea Statistics excluding maternal age ≤19 years and early preterm(gestational age ≤33 weeks). The study cases consisted of 2,227,741 births; 122,045 mothers(5.5%) were aged 20~24 years, 713,704 (32.1%) were aged 25~29 years, 1,020,910 (45.9%)were aged 30~34 years and 368,790 (16.5%) were aged ≥35 years. Results: The incidence of infants born LP was 3.5% during 2008~2012. Compared with primiparouswomen aged 20~29 years, the odds ratio of LP birth were 1.18 (CI: 1.15~1.21) for multiparouswomen aged 20~29 years, 1.13 (CI: 1.11~1.16) in primiparas versus 1.14 (CI: 1.11~1.16)in multiparas aged 30~34 years, 1.47 (CI: 1.42~1.52) in primiparas versus 1.38 (CI: 1.34~1.41)in multiparas aged 35~39 years, and 1.89 (1.76~2.03) in primiparas versus 2.06 (1.96~2.16) inmultiparas aged 40 years and over. Conclusion: Advanced maternal age in primi- and multiparous women was associated with LPbirth after adjusting for the maternal and infantile variables. There was a need for more researchin this area to understand the risk factors for LP birth.
참고문헌 (29)
- Brown HK, "Neonatal morbidity associated with late preterm and early term birth : the roles of gestational age and biological determinants of preterm birth", International Journal of Epidemioogy, 43, pp.802~814 (2014)
- Carter MF, "The late preterm birth rate and its association with comorbidities in a population-based study", American Journal of Perinatology, 28, pp.703~708 (2011)
- Chan BC, "Effect of parity and advanced maternal age on obstetric outcome", International Journal of Gynaecology and Obstetrics, 102, pp.237~241 (2008)
- Chan E, "School performance at age 7 years in late preterm and early term birth: a cohort study", Archives Disease in Childhood Fetal and Neonatal Edition (2014)
- Cheong JL, "Increasing rates of prematurity and epidemiology of late preterm birth", Journal of Paediatrics Child Health, 48, pp.784~788 (2012)
- Cohen W., "Does maternal age affect pregnancy out come?", BJOG, 121, pp.252~254 (2014)
- Dong Y, "An overview of morbidity, mortality and long-term outcome of late preterm birth", World Journal of Pediatrics, 7, pp.199~204 (2011)
- Fuchs K, "Elective cesarean section and induction and their impact on late preterm births", Clinical Perinatology, 33, pp.793~800 (2006)
- Klemetti R, "Associations of maternal age with maternity care use and birth outcomes in primiparous women : a comparison of results in 1991 and 2008 in Finland", BJOG, 121, pp.356~362 (2014)
- Kozuki N, "Child Health Epidemiology Reference Group Small-for-Gestational-Age-Preterm Birth Working. The associations of parity and maternal age with small- for-gestational-age, preterm, and neonatal and infant mortality: a meta-analysis", BMC Public Health, 13(Suppl 3), pp.S2~ (2013)
- Kuehn BM, "Scientists probe the role of clinicians in rising rates of late preterm birth", JAMA, 303, pp.1129~1136 (2010)
- Langhoff-Roos J, "Spontaneous preterm delivery in primiparous women at low risk in Denmark : population based study", BMJ, 332, pp.937~939 (2006)
- Lipkind HS, "School-age outcomes of late preterm infants in New York City", American Journal of Obstetrics and Gynecology, 206, pp.222.e1~222.e6 (2012)
- Lisonkova S, "The effect of maternal age on adverse birth outcomes: does parity matter?", Journal of Obstetrics and Gynaecology Canada, 32, pp.541~548 (2010)
- Loftin RW, "Late preterm birth", Reviews in Obstetric Gynecology, 3, pp.10~19 (2010)
- Park SH, "Risk factor of preterm delivery in pregnant women aged 35 years or older ; analysis of birth certificate data in 1996", Korean Journal of Obstetrics and Gynecology, 42, pp.1416~1421 (1999)
- Park SH, "Incidence of late preterm in Korean singleton birth", Journal of Reproductive Medicine and Population, 24, pp.110~116 (2011)
- 박상화, "우리나라 단태아의 임신기간 변화 추이: 1998-2009", 대한보건연구, 37(2), pp.57~62 (2011), 사단법인 대한보건협회
- 박상화, "40세 이상 고령 출산과 임신결과에 관한 연구", 대한보건연구, 39(2), pp.31~38 (2013), 사단법인 대한보건협회
- 박상화, "우리나라 후기조기분만 발생 추이에 관한 연구: 1995~2012", 한국모자보건학회지, 18(2), pp.209~217 (2014), 한국모자보건학회
- Park SH, "Trends of child birth in maternal aged 35 years and older (1981-2007)", Journal of Reproductive Medicine and Population, 22, pp.159~166 (2009)
- Quigley MA, "Early term and late preterm birth are associated with poorer school performance at age 5 years: a cohort study", Archives Disease in Childhood Fetal and Neonatal Edition, 97, pp.F167~F173 (2012)
- Schempf AH, "Maternal age and parity-associated risks of preterm birth: differences by race", ethnicity, 2007, pp.21, 34~43
- Shah PS, "Knowledge Synthesis Group on Determinants of LBW", PT births. Parity and low birth weight and preterm birth: a systematic review and meta-analyses, 2010, pp.89, 862~875
- Shapiro-Mendoza CK, "Epidemiology of late and moderate preterm birth", Seminar Fetal Neonatal Medicine, 17, pp.120~125 (2012)
- "Korean Statistical Information Services"[URL]
- Teune MJ, "A systematic review of severe morbidity in infants born late preterm", American Journal of Obstetrics and Gynecology, 205, pp.374.e1~374.e9 (2011)
- Trilla CC, "Maternal risk factors and obstetric complications in late preterm prematurity", European Journal of Obstetrics, Gynecology and Reproductive Biology, 179, pp.105~109 (2014)
- Vohr B., "Long-term outcomes of moderately preterm, late preterm, and early term infants", Clinics in Perinatology, 40, pp.739~751 (2013)